Pulmonary embolism and mortality following total ankle replacement: a data linkage study using the NJR data set

Razi Zaidi, Alexander MacGregor, Suzie Cro, Andy Goldberg

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OBJECTIVE: To determine the mortality rate following total ankle replacement (TAR) and incidence of 90 day pulmonary embolism (PE) along with the associated risk factors. 

DESIGN: Data-linkage study of the UK National Joint Registry (NJR) data and Hospital Episodes Statistics (HES) database. Linkage was performed in a deterministic fashion. HES episodes 90 days after the index procedure were analysed for PE. Mortality data were obtained pertaining to all the index procedures from the NJR for analysis. 

PARTICIPANTS: All primary and revision ankle replacement patients captured on the NJR between February 2008 and February 2013. 

RESULTS: The 90-day mortality following TAR was 0.13% (95% CI 0.03 to 0.52) and 1-year mortality was 0.72% (95% CI 0.40 to 1.30); no deaths were as a result of PE. The incidence of PE within 90 days following primary TAR was 0.51% (95% CI 0.23 to 1.13). There was only one PE following revision surgery. Patients with an Royal College of Surgeons Charlson score greater than zero were at 13 times greater risk of PE (p=0.003). 

CONCLUSIONS: There is low incidence of PE following TAR, but multiple comorbidities are a leading risk factor for its occurrence. 

Original languageEnglish
Article numbere011947
JournalBMJ Open
Issue number6
Early online date3 Jun 2016
Publication statusPublished - 21 Jun 2016

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